There exists a large variety of patient tables for medical applications, each of which is generally functional within a narrow range of clinical procedures due to its singular table top design as well as its overall configuration. However, in all cases, the table consists of two or three basic elements. Generally there is a table attached to a supporting mechanism and a means to move the table in various directions, including up and down. The moving mechanism may be manually operable or may be power assisted in many directions other than merely up and down. The ability to move the patient, once they are on the table is of importance to clinicians, as well desirable for accessibility to many of today's modern medical diagnostic or therapeutic devices, such as x-ray equipment.
The final configuration of a particular patient support unit is arrived at after contemplation of the various modes and methods available for support and mobility for the types of surgical access required, as well as satisfying the many conflicting clinical requirements.
Various types of tables have been designed and developed over the years for the positioning of the human body for various types of examinations and manipulations. Such tables tilt about one or more axes and they include various portions or sections which move independently or in concert. They generally allow the human body, or various parts of the human body, to be appropriately positioned, as desired, for the type of manipulation or examination to be made by a user of the table.
The tables may be operated or positioned by hydraulic pressure, by spring pressure, by manual cranking of cranks and gears, or by physically positioning the table at a predetermined location by virtue of racks, slots, and the like, cooperating with physical stops to effect the positioning and maintaining of the table, or a part of the table, in a particular orientation.
Various designs for patient tables and the support structure have been discussed. In addition to the general configuration of the table and its support element, the ideal configuration permits the elevation and tilt of the patient in both the longitudinal plane (positive longitudinal tilt is known as Trendelenberg and negative longitudinal tilt is known as reverse Trendelenberg) and the lateral plane.
Additionally, tables may be designed to “float” the patient relative to the support mount. A floating table is one which moves in a predetermined plane on bearings mounted in a frame which is affixed to the support mount. While floating tables are ideally suited to radiology procedures, such configurations are not deemed acceptable for surgical procedures. Their unacceptability for surgical procedures is result of the patient's tethering to anesthesia equipment or other life support equipment.
Many surgical procedures require that a patient's body part, such as a limb, portion of a limb, extremity, organ or tissue be positioned in a number of different positions for the performance of a surgical procedure. It is desirable that the operating surgeon or surgical assistant be able to move the limb or other body part into other positions and configurations that may be required during the course of the surgical procedure. It is also desirable that any positioning apparatus that may be used to achieve such positions and configurations not obstruct the surgical site, and be able to avoid any obstacles that may exist around the surgical site, such as medical imaging systems, operating room lights, instrument trays, or other apparatus.
Various methods for positioning and supporting a patient's limb or body part are known in the prior art. One common method for positioning a body part is to have a sterile surgical assistant hold the body part in a desired position, and change the position when and as requested by the operating surgeon. This task is fatiguing for the surgical assistant, and this technique may not support the patient's body part in a sufficiently precise and rigid manner for the surgical procedure. Other typical methods for positioning a patient's limb are to rest the limb on a table for that purpose, to hang the limb over part of the operating room table, or to rest the limb on the lap of a seated operating surgeon. All of these techniques offer a very limited range of possible limb configurations, serve to restrict the movement of the surgeon, and result in reduced precision and rigidity of support.
In addition to the methods for positioning illustrated above, apparatus for supporting and positioning body parts exists in the art. One common supporting means consists of slings attached to the patient's limb, ropes and occasionally weight, which are hung over or tied to operating room light fixtures, intravenous fluid support stands, or other operating room fixtures, in order to suspend the limb. These types of supporting means are difficult to set up and take down, clumsy to adjust, and often obstruct the surgical site. Furthermore, adjusting such apparatus to achieve a new position may require the assistance of a non-sterile person, in that operating room fixtures and support stands that may require re-positioning are not considered sterile, hence cannot be touched by a surgeon. This may preclude optimal positioning of the limb or body part, as the surgeon may no longer have direct control over the final position of the limb or body part.
However, these known methods and structures all have various drawbacks, such as being cumbersome and difficult to install, use and adjust. Furthermore, many of these devices and methods are difficult, if not impossible, to adapt to various locations on the operating table. Still further, some of the known devices interfere with sight lines as well as access to the patient. Thus, these known devices have not been readily accepted by health care professionals.
Therefore, there is a need for a means and method for securing patient or a patient's body part securely to an operating table in an efficient yet secure manner and in a location that is most efficient for the procedure.